Third Party Payer Disputes
We represent healthcare providers in disputes with third party payers. We protect the financial interests of physicians and other healthcare providers with regard to, for example:
- Claim denials by insurers and other third party payers
- Improperly delayed claim reimbursement by third party payers
- Billing and coding disputes with third party payers
- Breach of contract by third party payers
- Internal complaints, appeals and administrative remedies
- Litigation, arbitration and mediation
Our law firm has represented numerous physicians and other healthcare providers in complex legal matters.
“Kevin Little [of Hamil Little] represented the Medical Association of Georgia and individual physicians in a matter addressing the abuses of the health insurance industry. Kevin [of Hamil Little] was a pleasure to work with and brought forth legal theories to hold the health insurance industry accountable to physicians and patients. We received outstanding representation from Kevin [of Hamil Little].” *
Donald Palmisano, CEO and General Counsel, Medical Association of Georgia.
Our healthcare law firm’s offices are located in Augusta and Atlanta, Georgia. We represent clients principally in Georgia and South Carolina. (See Communities We Serve.) Our attorneys have extensive experience as trial and business attorneys and hold Martindale Hubbell's AV rating, its highest rating. To schedule a consultation, email us at email@example.com or contact us at our office nearest you.Protecting the Financial Interests of Healthcare Providers
Most of us, as consumers of healthcare, tend to view doctors only as providers of care. But they and other healthcare providers -- pharmacies, ambulatory service centers, nursing home and elder care entities, ambulance services, and many others – are businesses. As healthcare consumers, we need healthcare businesses to thrive and be profitable.
Unfortunately for all of us, it is increasingly difficult for medical practices and other healthcare businesses to thrive financially in a cumbersome third-party payer system of reimbursement complicated by red tape, stingy and overreaching insurers, and expanding governmental regulation. More than ever, making a happy living is an elusive objective for many doctors and other healthcare businesses. This is a problem for all of us, not just them. The Accountable Care Act will greatly complicate the healthcare system further and make it more difficult for healthcare businesses to succeed financially.
Our law firm has special experience and interest in helping doctors and other healthcare businesses succeed. An objective of our law firm is to protect healthcare providers and advance their financial interests. We have represented physicians, physician groups, ambulance services, healthcare centers and other healthcare related businesses in transactional, administrative and litigation matters.
We have considerable experience in third party payer disputes. For example, we represented an Independent Physicians Association, comprising over 50 doctors, in a complex arbitration filed against a major health insurer based on allegations that the insurer took financial advantage of the doctors. Through our and co-counsel’s efforts, the IPA doctors succeeded in recovering over $5 million in the arbitration, which had been improperly withheld by an insurer. Kevin Little has represented physicians in other types of healthcare and managed care disputes that impact medical practices.
* DISCLAIMER: Any result this law firm or any lawyer of this law firm may achieve on behalf of one client in one matter does not necessarily indicate similar results can be obtained for other clients.